Chandigarh, August 12
PGI cardiologists have been able to repair a massive heart rupture without using open heart surgery. This, they say, is the first case in the world when a fatal heart disease like a heart rupture has been corrected without surgery.
Open-heart surgery can also be used to repair heart damages but it requires surgeons to open up both sides of the heart. Naturally, it puts strain on the body and around half of patients who undergo the procedure die.
The achievement of PGI doctors is commendable considering that 95 per cent cases of heart rupture end in mortality. Heart rupture is mainly caused by heart attacks and sometimes by blunt heart injury. The condition is more common among elders, women and diabetics. Heart rupture in turn is an important cause of sudden cardiac deaths.
The medical breakthrough was achieved on August 5 by a team of PGI’s interventional cardiologists led by Dr Harinder Bali, who used an 8 mm-wide mechanical device to plug the vent in the heart of a 35-year-old man from Kangra. Raj Kumar the patient, had a history of cardiac disease from aged 15 and had been seeking treatment at the PGI. In 1990, he was diagnosed with Apical Hypertrophic Cardiomyopathy — a rare heart muscle disease.
The patient had been coming to the PGI for follow up since then. In 2000, he reported severe chest pain. Because of the persisting symptoms, he was admitted for angiography which revealed a rupture of his left ventricle.
Dr Bali explained: “The patient developed pseudo aneurysm (a false pouch) of the heart due to the underlying heart muscle diseases. Subsequently the pouch ruptured and caused clotting of the blood (hematoma) on the front surface of the patient’s heart, inside pericardial covering of the heart. He, quite unusually, survived. Over a period of time, the clot got calcified. Meanwhile he continued to have the pouch which kept leaking into the pericardium. Since massive blood diffusion had taken place, he ran the risk of fatal rupture or paralytic stroke. The only option was surgery.”
The patient was however reluctant to undergo surgery. It
was then that the cardiologists decided to treat him using a less-invasive procedure. The one they used has proved to be a huge step forward in the field of interventional cardiology. On August 5, the cardiologists put the patient on local anesthesia and plugged his ruptured false sack per-cutaneously by using the mechanical device — Amplatzer. In medical literature, only two cases have been reported from Germany and UK in which a mechanical device was used to treat such false pouches which had not yet ruptured.The device which PGI cardiologists used costs one lakh and is manufactured abroad. As regards cost of treatment, both open-heart surgery and the new interventional technique evolved at the PGI cost almost the same.
Commending the achievement, the PGI Director, Prof K.K. Talwar, also Head of the Department of Cardiology, said the new innovative method was a very good way of helping patients who do not want to undertake open-heart surgery. “You certainly need a high level of expertise to execute such procedures. These sorts of lab procedures are very encouraging as the patient need not be taken to the operation theatre. We will be sending the case to international conferences so that we can invite peer reviews on the same,” he said.
